Loolwa Khazzoom, writer and chronic pain patient, has started a really interesting new blog called Dancing with Pain. It’s chock full of therapeutic ideas, insightful commentary, and, luckily for me, guest bloggers. She invited me to write for her site and the post is up here. Check it out, and stay awhile–she’s got a lot to share!

So we had a heated discussion in one of my classes this week about patient confidentiality and gossip. Just this morning, I saw this link about a ban on gossip posted on Paul Levy’s blog, Running a Hospital, and figured the forces were aligning in such a way as to warrant a post.

Specifically, we discussed the types of conversations that take place at nurses’ stations, cafeterias, and outside patient rooms. Everyone was adamant that a certain amount of patient information needs to be shared between shifts and between providers for optimal patient care. But they were worried about the fine line between what is medically necessary information and what is merely gossip, particularly when it is shared within earshot of other patients, families, and visitors. They’re all familiar with the axiom “Don’t take it home” in regards to patient information, but several of them wished there was something more concrete in place to help them navigate that precarious line.

Patient confidentiality certainly raises timely questions, and one without easy answers. For example, if a patient has a roommate, there is no way to avoid some information transfer to that roommate and his or her visitors. But when one patient’s relative has extremely detailed knowledge of the roommate’s lab results, family situation, and legal issues, then confidentiality has been breached.

I can approach their discussion from a different perspective. I can see why healthcare providers would need to know about changes in my physical and emotional states when I am an inpatient, and I want them to know if it means they can better address my needs.

On the other end of the spectrum, I once bumped into a medical assistant from my endocrinologist’s office at a bar. She introduced me to her friends as her patient, asked me if my new dose of medication (which she named) was working, and told them I was a difficult stick for blood draws. (She wasn’t sober, can you tell?) I was not impressed. At all. Obviously this is an egregious example way outside the bounds of the classroom conversation, but yet it’s still part of the conversation.

I know that my colleagues and I face similar boundaries in sharing student information. It’s one thing to describe a classroom situation and seek advice or bounce around ideas about how to handle it, or to very generally describe someone’s extenuating circumstances when in committee meetings to discuss failing grades. It’s another thing altogether to reveal any specific, personal information that has been shared with us, and we need to make the same kinds of distinctions between what will help us best help our students and what should always remain confidential.

I think in any profession where you establish relationships with people, where trust and respect develops and you begin to really care about people, you’re going to confront these issues. If you didn’t care, the details wouldn’t matter.

But knowing that doesn’t make it any easier in the moment, does it?

Got sleep stories?

I’m writing an article about new research on sleep and looking for anecdotes from women who’ve struggled with sleep. Everyone knows it’s important, everyone knows we need more of it, and no one gets enough of it.

So what did it take for you to finally make a change in your life and get better sleep? If you have an “aha” moment, e-mail me (see e-mail link on sidebar) and let me know about it. I’m eager to hear about what you’ve done to make a change, and what it took to get you there. Thanks so much!

Recent debates and primaries stoked your political fire a bit? Does healthcare (and what candidates plan to do about it) matter a lot to you?

Check out this week’s Ground Rounds at Sharp Brains where the future president is queried with all sorts of pressing healthcare issues. It’s a great read!

It was like being a kid all over again. At night, I listened to weather reports and compared varying levels of expected snowfall. The words “snow day” danced around my head, tantalizing me. As soon as my eyes opened in the morning, I peered out the window and headed right to my computer to see if classes had cancelled. I felt the same rush I used to feel when I realized I did not need to put on my uniform and trudge to the bus stop…

…And then I plunked down at my computer and dove into work, excited that I had such an early start and a whole day to catch up on projects and hopefully get ahead on others stretched before me.

Oh, how times have changed.

My snow-induced day of productivity was just what I needed, and made me think back to another hallmark of my childhood days, my mother-induced “mental health days.” Once in awhile, my mother would let me and my brothers take a day off from school just because. Think of it as a kid equivalent of a personal day. We could do whatever we wanted, whether that meant playing board games, watching television, or going out to lunch.

Considering how many weeks of school I missed every single year due to my illnesses, not everyone everyone understood her rationale in allowing me to miss even more. Yet it was precisely because I missed so much school for unpleasant things—surgeries, infections that left me fairly lifeless on the couch, doctor appointments, diagnostic procedures and tests, etc—that it was even more important to my mother that I have a day every now and then where I didn’t have to think about school or sickness.

If it was important for the healthy kids to just take a mini-break from school and sports and extracurriculars (and it was important), then it made sense for the sick kid to get a break from her own realities, too.

Invariably, I never made exciting plans for my mental health days. Sometimes we got lunch at Friendly’s, other times we just watched Little House on the Prairie. Most often, I read books. Since whenever I normally had the chance to just hang out I was either feeling too sick to enjoy it or was too busy catching up on schoolwork, these simple activities were all I wanted or needed.

And reading a book on the couch or in my canopy bed, as opposed to the waiting room of yet another doctor’s office? Bliss.

Everyone I talked to yesterday who had a snow day or some sort of improvised telecommute commented on how welcome it was. After a hectic week of moving, unpacking, and getting over a fairly nasty infection, a day to catch my breath and take stock of what I needed to do was the best mental health day I could imagine. Nothing makes me feel better than knowing I’m crossing things off my To Do List and by last night, I was feeling so much better about facing the rest of the week.

True, what makes for a mental healthy day in my world has changed a lot since the days of Little House, but whether you’re sick or perfectly healthy, my mother was certainly onto something—an unexpected break in your routine can do wonders for psyche…And when you’re an adult, sometimes you just need a good old-fashioned snowstorm to force that break.

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Don’t forget the polls are still open over at Medgaget! If you’re so inclined, click here to cast your vote for A Chronic Dose in the “Best Literary Medical Weblog” category.

I am very pleased–and quite humbled–to announce that A Chronic Dose was named a finalist in the Best Literary Medical Weblog category. To even be in the running with such wonderful sites is an honor, and I thank you very much. Click Here to visit Medgadget and vote. The polls are now open, so click over and cast your vote!

As some of you regular readers know, New Year’s has special meaning for me. Four years ago this evening, I met the man who would become my husband. I had also just gotten out of the hospital again, and that winter marked a turning point for me in terms of diagnosis and treatment. Since then, every New Year’s that I’m not in the hospital or acutely ill is a milestone.

Healthwise, I’ve come a long way since then.

We’ve come a long way since then, and each year we mark each New Year’s with a special dinner or celebration.

Not this year. He’s bedridden with a stomach bug that has left him dehydrated and weak, and I’ve come down with another respiratory infection. So we’re spending New Year’s in sick bay, armed with tissues and tea cups, our fancy dinner out likely replaced with chicken broth and ginger ale.

We were at a wedding this past weekend–an especially lovely and joyful one–and the “in sickness and in health” sentiments are fresh in my mind. Eh, so we won’t have expensive wine and good food. Who cares. At least we’re in the trenches together–and since neither of us are in the hospital, it’s still a good end to the year yet.

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Speaking of being in the trenches, the December Pain-Blog carnival is up now at How To Cope with Pain, including an entry from A Chronic Dose. During the last week of each month, the best posts of that month are highlighted. New bloggers are always welcome to contribute. There’s plenty of good reading and tips to start 2008 off the right way!

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A Chronic Dose has been nominated for the 2007 Medical Weblog Awards for Best Literary Blog (my little MFA heart is fluttering just a bit at this) and Best Patient Blog. It is an honor to even be nominated and stand next to such high-quality sites, so I thank you very much for the nod. Voting for the finalists begins Jan. 8th.

A Chronic Dose has been nominated for the 2007 Medical Weblog Awards (!) for Best Literary Blog and Best Patient Blog. Voting starts Jan. 8th.

Last week I was tagged by Dayna at A Bug’s Life and Barbara K at In Sickness and In Health for the “7 Random Things” meme. I am getting to it a few days later and I am studiously ignoring my husband’s little smirk that says “Only seven random/weird things? However will you narrow it down?” but I am getting to it nonetheless.

With no further delay, seven things you wouldn’t necessarily know from reading this blog:

1. I once broke my finger when someone hit my hand with a balloon. Yes, a balloon. When I rock my bone density scans, I am the only one there under 80. Good times.

2. I have an amazing capacity for monotony–when writing my book, I listened to the same song on repeat. Six days a week for six months. I only changed it once for half of a song and when I did, I couldn’t string a sentence together.

3. I spent a year studying at Trinity College, Dublin and while there, I went spelunking off the west coast of Ireland, near the Cliffs of Moher. See #1 on this list to understand why my relatively unscathed return from this trip was momentous.

4. I was a competitive figure skater (solo and precision team) for several years when I was in grammar school. Again, see #1 on this list and pretty much any random entry on this blog to see why that could never end well. I had heart, but my various plaster casts made for some lopsided spins and jumps.

5. I went to an all-girls’ Catholic high school run by nuns. Instead of bells to signal the beginning/end of class, we had classical music. If you hadn’t arrived at your next class by the last violin strain, you were in trouble. Looking back, this seems really weird to me, but at the time I thought that was how everyone did it.

6. My mother wanted me to be a Latin teacher when I grew up. I was kind of a Latin dork. I got perfect scores on the National Latin Exam and spent surreptitious weekends in May competing in the state Latin/mythology championships at the behest of the little nun who taught my high school Latin classes. My brothers forbade me from telling anyone this. I’ve forgotten a lot of what I knew then, but every now and then an arcane mythological reference comes to me or some Latin idiom crosses my mind and I realize I am still a dork.

7. I’m extremely competitive and I am a terrible loser. My husband and I have a running Scrabble competition–I am up 37 games to 32, but who’s counting? Whenever it looks like I am going to lose, he claims I suddenly get “really tired.” Lame of me, I know.

According to the rules, I must now tag seven other bloggers:

Girl, Dislocated, because she is hilarious. And has broken waaaayyy more bones than me!

I’d Like to Buy a Bowel, because she is also really funny, and brings new meaning to toilet humor

Rickety Contrivances of Doing Good, because she is so creative and reflective

Sick Girl Speaks, because she is incredibly wise. (She also just published her own book and I had the pleasure of reading it!! Wonderful work, Tiffany!)

Sick Momma, because I think she’d have really interesting entries for her list of seven things

Fluent, because I think her arm is better and I’m hoping she’s up for it!

A Medical Mystery, because she’s really honest

Here are the rules:
1) Link to the person that tagged you, and post the rules on your blog.
2) Share 7 random and/or weird facts about yourself.
3) Tag 7 random people at the end of your post, and include links to their blogs.
4) Let each person know that they have been tagged by leaving a comment on their blog.